Extracorporeal Shock Wave Lithotripsy (ESWL) Procedure for Kidney Stone Treatment

ESWL, known as a healthcare technology used in kidney stone disease, is the process of breaking kidney stones with sound waves. No invasive procedure is performed on patients during this treatment. Kidney stones are shattered into pieces using sound waves provided externally to the body. As the kidney stones reduce to a very small size, the body expels them through the urinary tract. The ESWL procedure, which does not require anesthesia, typically lasts about 45 minutes. However, in some cases, anesthesia may be administered to the patient before the procedure.

Preparation Process Before ESWL
The pre-preparation process for ESWL is quite simple as the procedure generally does not require anesthesia, except in special cases. Patients using diabetes and hypertension medication can continue their medications during this process. However, if patients are using blood thinners, they need to stop using the medication a few days before the procedure. Pain relievers are given to patients before the procedure to ensure they do not experience any discomfort or pain during the process.

How is the Kidney Stone Breaking Procedure Done with Sound Waves?
In the ESWL procedure, which involves breaking kidney stones with sound waves, the exact location of the stone is first determined using ultrasound (USG). Then, focusing on the kidney stones, the sound waves are directed towards the stone. The patient may feel vibrations in their body during this process. With the procedure lasting an average of 30 to 45 minutes, the process is completed. The number of ESWL sessions varies depending on the size of the stone. If the kidney stone is large, one session may not be sufficient. Therefore, a maximum of two additional sessions may be administered to the patient. After this procedure, patients should drink plenty of water to facilitate the easier expulsion of the fragmented kidney stones from the body.

Which Types of Kidney Stones is ESWL Applied to?
Individuals suffering from kidney stone disease can get rid of this problem with ESWL treatment, depending on the type and size of the kidney stone. Therefore, it can be said that the process of breaking kidney stones with sound waves is indeed very effective. This procedure is generally applied to patients with kidney stones smaller than 2 cm.

Advantages of ESWL Treatment Compared to Other Kidney Stone Treatments

• Anesthesia is generally required for PNL, URS, and RIRS methods among kidney stone treatments. In ESWL treatment, anesthesia is not typically administered.
• Patients undergoing PNL and RIRS treatments require hospitalization, which is not necessary for ESWL treatment.
• ESWL is not a surgical procedure and is administered externally to the body.
• It is particularly effective when applied to patients with small kidney stones.

Conditions Where ESWL Treatment Cannot Be Applied

• Pregnancy
• Individuals at high risk of bleeding
• Untreated urinary tract infection
• Individuals with uncontrollable high blood pressure
• Aneurysm in abdominal blood vessels
• Overweight patients (breaking stones becomes more difficult when the distance between the skin and the stone is more than 10 cm)
• Patients with urinary tract obstruction (broken stones cannot be expelled from the body through the urinary tract)
• When the kidney stone is very hard
• When the size of the kidney stone is large
• When the stone is located in the lower part of the kidney

Role of ESWL in Kidney Stone Treatment
ESWL, not considered a surgical procedure, does not require hospitalization for the patient. Many kidney stone patients prefer ESWL because it is a very effective treatment method. However, although beneficial, it is not entirely innocuous. Therefore, it is not recommended to exceed three sessions. Additionally, depending on the location, size, and hardness of the stone, URS and PNL treatment methods can be considered alongside this treatment. Moreover, the RIRS treatment, which is one of the most successful methods in recent years, can also be preferred.